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This is Dr. Bill Adams of the Adams Center in Newbury Street in Boston. Today I wanted to talk a little bit about rhinoplasty. This is one of my favorite operations. The reason it is is it is interesting from a three-dimensional viewpoint. Anything you do on one part of the noise from one direction affects the appearance on the other direction.

The anatomy of the nose is pretty simple. There are two nasal bones, two cartilages, two more cartilages at the tip, the second running down in the middle and then the skin overlying that.

In a typical rhinoplasty, the patient wants to have something done with the bump and or the tip. The way I like to do this is from incisions inside the nose to get exposure to the cartilages at the tip and to the top of the nose, and then we gently smooth the top of the nose to make this a straighter line, trim this part to make it look, what people call the ball tip of the nose, less prominent, and then reposition the nasal bone from inside to recreate the normal contour of the nose.

The end goal is to have a relatively straight line from here to here with good definition of the tip with the same approximately 110 degrees, so that it looks good either from the front, three-quarters or the side.

The most important thing is if the nose fits the face. You have to look at the overall shape of the face, the prominence of the chin relative to the forehead, and then have that nose fit into that. The goal at the end is to have the nose look better without anyone knowing that you've had anything done.

These Are the Factors That Determine a Rhinoplasty's Success

Dr. William Adams explains the anatomy of the nose, as well as the factors that determine if a rhinoplasty's been successful.

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